Last year, RAMP and our partners made groundbreaking progress changing policies to increase access to asthma home visiting services for Californians with poorly controlled asthma. In 2023, we are excited to see these policies more fully enacted to integrate in-home education, trigger assessment and environmental remediation into the health care system.
With these policies in place, California is a national leader in providing comprehensive asthma home visiting services, which improve health outcomes, reduce health care utilization costs, and reduce asthma disparities.
Updated Asthma Home Visiting Program Directory
To support the implementation of these policies, last spring RAMP, in collaboration with partners in the field, developed the first-of-its-kind public directory of asthma home visiting programs in California to showcase the strength and breadth of the state’s asthma home visiting network and to connect Medi-Cal managed care organizations and other stakeholders with local programs. View the updated directory here.
Read on for an overview of how these new policies and our related efforts are helping people with poorly controlled asthma.
Asthma Remediation under Community Supports
January, 2022, marked the launch of a new Medi-Cal program that allows Managed Care Plans (MCPs) to use Medicaid funding to pay for home trigger remediation for people with poorly controlled asthma.
Medi-Cal’s Community Supports program provides the option for MCPs to provide certain services that aren’t covered by Medicaid in place of traditional health care interventions. With advocacy from RAMP and our partners, the Department of Health Care Services included Asthma Remediation as one of fourteen Community Supports options.
More and more MCPs are now offering Asthma Remediation to their beneficiaries with poorly controlled asthma, often by leaning on the network of existing asthma home visiting programs in California. MCPs can opt in to select Asthma Remediation at the beginning and mid-point of the year, and RAMP continues to encourage MCPs to opt in.
For a fact sheet on Asthma Remediation, click here.
Asthma Preventive Services Benefit
Effective July 1, 2022, Medi-Cal covers Asthma Preventive Services. The new Medi-Cal benefit covers clinic- and home-based asthma self-management education and in-home environmental trigger assessments provided by non-licensed professionals such as Community Health Workers, promotoras, and other individuals meeting specified qualifications. RAMP developed this fact sheet to assist with the benefit’s implementation in the field.
Highlights of this new benefit include:
- Medi-Cal will cover asthma self-management education for all beneficiaries with a diagnosis of asthma. The in-home environmental trigger assessments will be available to beneficiaries with poorly controlled asthma.
- The new benefit is applicable in a range of settings: the in-home trigger assessments can take place in a client’s home, an assisted living facility, or a group home; asthma self-management education can be provided in any of the aforementioned settings or a clinic setting.
- Professionals providing Asthma Preventive Services will need to complete a training program that covers components specified by DHCS, which align with current best practices and available training programs, including the Asthma Management Academy.
- While the federal rules require supervision of the Asthma Preventive Services providers, California is taking a flexible and inclusive approach. The supervising provider can be a physician, physician assistant, nurse practitioner, clinic, hospital, local health jurisdiction, or community-based organization. Such diversity aligns well with California’s diverse home visiting programs.
For more information from DHCS, please see this news release, the Asthma Preventive Services provider manual, and the RAMP fact sheet mentioned above.
Advancing the role of Community Health Workers, promotoras, and other non-licensed professionals
In addition to the new asthma-related Medi-Cal policies, the state has also adopted a different Community Health Worker benefit that will better integrate the use of CHWs throughout the Medi-Cal system. For additional information about this benefit and RAMP’s role in supporting CHWs, click here.
The key role of Managed Care Plans
MCPs are a fundamental part of California’s Medi-Cal landscape and play a key role in increasing access to asthma home visiting services for their beneficiaries. These services can help fulfill MCPs’ mission, and there are many opportunities MCPs can take advantage of to move forward.
To highlight the MCO-related benefits and opportunities of asthma home visiting services, RAMP and the National Center for Healthy Housing (NCHH) developed Unlocking the Power of Home-Based Asthma Services: Model Health Benefit Packages. The resource equips managed care organizations or other healthcare payers with the information they need to improve asthma management among their enrollees by ensuring the provision of asthma home visiting services. It also addresses the key roles that other community, state, and federal stakeholders play in motivating and supporting healthcare payers in this effort. Learn more about the resource here.
Elevating the value of partnerships
RAMP is proud of the leadership role we’re playing in the program and policy progress in California. Equally important to our success is the partnership and collaboration with a wide-range of many other asthma, health, housing and equity stakeholders, including the California Pan Ethnic Health Network, Children Now and dozens of other committed advocates who continue to share their time, expertise and advocacy.
This collaboration thrives in a variety of networks, including the California Asthma Financing Workgroup (facilitated by RAMP) and the Asthma Mitigation Project, a state-funded grant program for asthma home visiting programs administered by The Center at Sierra Health Foundation (RAMP is a technical assistance provider to Project grantees).
How RAMP can help
We are delighted to offer Technical Assistance to asthma home visiting programs, managed care plans, and others interested in advancing asthma home visiting services. Please see our description of TA services for more information.
Would you like to learn more or have clarifying questions? Don’t hesitate to reach out to us at info@rampasthma.org/.
